<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select  id="c-status" data-rule="required" class="form-control selectpicker" name="row[status]">
                {foreach name="statusList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row['status']"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Balance')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-balance" class="form-control form-control" step="0.01" name="row[balance]" type="number" value="{$row.balance}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Integral')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-integral" class="form-control form-control" step="0.01" name="row[integral]" type="number" value="{$row.integral}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Voucher')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-voucher" class="form-control form-control" step="0.01" name="row[voucher]" type="number" value="{$row.voucher}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Phone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone" class="form-control form-control" step="0.01" name="row[phone]" type="number" value="{$row.phone}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Phone_days')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone_days" class="form-control form-control" name="row[phone_days]" type="number" value="{$row.phone_days}">
        </div>
    </div>


    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
